Severe Respiratory Alkalosis in Acute Ischemic Stroke: A Rare Presentation.

Vijayadershan Muppidi,Sreenath Meegada,Vasuki Dandu,Sashank Kolli,Samata Pathireddy

doi:10.7759/cureus.7747

Abstract

Respiratory alkalosis is a rare but severe complication of acute ischemic stroke (AIS). In ischemic stroke, respiratory alkalosis results from hyperventilation due to the effect of stroke on the respiratory center. We report a case of a young male who presented with acute encephalopathy. Work-up revealed ischemic infarcts in the bilateral cerebellar and left posterior cerebral artery territory. Arterial blood gas (ABG) showed severe respiratory alkalosis with a pH of 7.72. Alkalosis resolved with mechanical ventilation. Such a high pH associated with AIS has not been reported in the medical literature so far. The index case highlights the severity of respiratory alkalosis that can be caused by an AIS. We conclude that early diagnosis and management of severe respiratory alkalosis is crucial for survival and recovery.

Highlights

Stroke has a significant healthcare burden across the world
We report a case of a young male who presented with acute encephalopathy
According to the 2013 guidelines from the American Heart Association/American Stroke Association (AHA/ACC), acute ischemic stroke (AIS) is an episode of neurological dysfunction due to restriction of blood supply to a part of the central nervous system leading to the brain, spinal cord, retinal cell injury/death [2]

Summary

Introduction

Stroke has a significant healthcare burden across the world. In 2009, one out of every 19 deaths in the United States was attributable to stroke [1]. We report a case of AIS that caused severe respiratory alkalosis with a pH above 7.7, one of the highest pH associated with ischemic stroke reported in the medical literature so far. How to cite this article Muppidi V, Kolli S, Dandu V, et al (April 20, 2020) Severe Respiratory Alkalosis in Acute Ischemic Stroke: A Rare Presentation. Arterial blood gas (ABG) was obtained and showed severe alkalosis with a pH of 7.72, with pCO2

Discussion

Conclusions

Disclosures

Finsterer J